Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Renee M. Soderquist, RD

Individual provider Registered Dietitian · NPI 1124280557

Renee M. Soderquist, RD is a Registered Dietitian OR Nutrition Professional in Fullerton, California. Qualified in 2006, 20 years ago. Practices with Providence Medical Foundation, a 1,465-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
20
Licensed in
CA
In the registry since
2008
What do these letters mean?
RD — Registered Dietitian
A credentialed nutrition professional.

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Practice location Address checks out

100 E Valencia Mesa Dr Ste 105
Fullerton, CA 92835-3813
Phone: (714) 446-5640
Fax: (714) 446-5625
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence R711364 (CA)

Record details

NPI number1124280557
Entity typeIndividual (Type 1)
GenderFemale
Credentials RD
Sole proprietorNo
NPI enumeratedJune 26, 2008
Last updated in NPPESNovember 15, 2018
Mailing address100 E Valencia Mesa Dr, Suite 105, Fullerton, CA 92835-3813

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyREGISTERED DIETITIAN OR NUTRITION PROFESSIONAL
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Providence Medical Foundation — 1465 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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